This is Steven Salzberg's blog on genomics, pseudoscience, medical breakthroughs, higher education, and other topics, including skepticism about unscientific medical practices. Here's where I can say what I really think about abuses and distortions of science, wherever I see them.

It took the General Medical Council (in the UK) nearly three years, but they finally issued a ruling about Andrew Wakefield's 1998 study that claimed a link between the MMR vaccine and autism. They ruled that he had acted "dishonestly and irresponsibly" in his research, and further that he didn't have the qualifications to be carrying out some of the experiments on children that he subjected them to. These experiments included colonoscopies and lumbar punctures, potentially dangerous and painful procedures. They also ruled that he behaved unethically when he paid the children £5 for their blood samples at his son's birthday party. (No, I'm not making this up.) He also filed for a patent on a "safer" vaccine that he was hoping to sell after he discredited the MMR vaccine. The GMC found all these behaviors amounted to "serious professional misconduct."

I've been writing about Wakefield's fraudulent for several years now, including posts last month, April 2009, April 2008, March 2008, and earlier. Many other scientists have written about him too, revealing that he was paid large sums of money by a lawyers' group for his research (which he failed to reveal to his collaborators or to the Lancet, where he published his work - another ethics breach pointed out by the MRC).

What's so awful about Wakefield's behavior is that it has directly contributed to a decline in vaccination rates, first in the UK and then in the US and elsewhere. A rise in measles cases - including a number of fatalities - can be directly attributed to this decline, as the BBC pointed out and illustrated with this figure:But it's not just measles: the anti-vaccine hysteria that Wakefield has encouraged over the years - and he's still at it - has also resulted in declining rates of vaccination for other childhood diseases, as I explained in my December 2009 post.

Meanwhile, scientists have conducted dozens of studies involving over one million people, searching for a link between vaccines and autism. No such link was found, because it doesn't exist. The Institute of Medicine conducted 8 studies and concluded after exhaustive research that vaccines had no link to autism. Despite this, Wakefield remains defiant and continues to claim that vaccines cause autism, despite the thorough discrediting of his 1998 study, which only involved 12 hand-picked children.

How did he respond today? He's still defiant: in an interview outside the hearing room, he said the charges were "unfounded and unjust" and then he proceeded to thank "the parents" who have supported him. And they have! As reported in The Times of London, he now pays himself a salary of $270,000 from his nonprofit corporation, Thoughtful House, which is supported mostly by donations. He lives in a wealthy suburb of Austin, Texas. And over at his TH website, he's posted a statement that repeats his claims that this is unfair, and that he is "dedicated to the recovery of these children." The statement goes on to warn about the possible link between MMR vaccines and autism. Wakefield really has no shame.

So finally the GMC did the right thing. But they acted far too late to prevent the damage caused by Wakefield's fraudulent study. I can only hope that their official action now will change the minds of at least a few of Wakefield's misguided supporters.

References (because I often get asked)There are many studies showing that vaccines are safe and that there is no link to autism. The first one below is one of the largest, involving over 537,000 children (compared to just 12 in Wakefield's original study):K. Madsen et al., A Population-Based Study of Measles, Mumps, and Rubella Vaccination and Autism, New England Journal of Medicine, 347:1477-1482 (November 7, 2002).In this study, the vaccinated children were slightly LESS LIKELY to become autistic. The authors' own conclusion is "This study provides strong evidence against the hypothesis that MMR vaccination causes autism."

It’s over. Or it’s nearly over. The great influenza pandemic of 2009 – often called the swine flu – has peaked and declined, and it might be over until next year. Not only is it over, but in a remarkable demonstration of evolution at work, it may already have pushed the “old” seasonal flu out of the human population.

Don’t get me wrong: it could still come back in a second wave, as epidemiologists at the CDC and the WHO have been warning. They’re right, too: we just don’t know enough about this pandemic to be sure it’s over. Dr. Keiji Fukuda from the WHO said on Thursday:

“We see that activity is declining or has declined but we also continue to see in these areas a transmission of the virus, so it has not disappeared, and it is has not gone back to baseline. Based on the situation, our current assessment is that it remains too early to say that the pandemic is over. And it is unclear whether we will see in the northern hemisphere over the next few months during the winter and spring period another significant wave of activity.”

Further down in this post I’ll show why I think it’s over. I think this is great news, but not surprisingly the conspiracy theorists have to make some wild claims to grab attention while there’s still time. Let me address them first.

As reported in the Irish Times, the UK Daily Mail, and elsewhere, the WHO is being accused of inventing the pandemic in order to boost the profits of drug makers. Where did this conspiracy theory come from? Why, my old friend Wolfgang Wodarg, head of health at the Council of Europe:

“Council of Europe parliamentarian Wolfgang Wodarg called for an inquiry into what he called a `false pandemic' and the way it was handled at national and European levels, claiming pressure from pharmaceutical firms.” (Source: Irish Times)

Wodarg’s resolution calling for an investigation was just passed by the Council of Europe.

The last time I wrote about Wodarg, he was claiming that the flu vaccine causes cancer. As I wrote then, Wodard doesn’t know beans about the flu. Anyone who makes such unfounded, irresponsible claims deserved to be ignored, but because he’s a high-profile politician, the WHO had to respond. Dr. Fukuda, speaking for the WHO, said:

“The allegation by some, that the H1N1 pandemic is a fake is both scientifically wrong and historically inaccurate.”

As for the conspiracy claim, he said

“WHO has reached out to all parties who could help to reduce harm from the pandemic but we did take very great care to make sure that the advice received was not unduly influenced by commercial or non-public health interests.”

As for whether it was real, this map shows the deaths caused by pandemic flu this year: You don’t have to be an epidemiologist to see that this has been a worldwide pandemic, with plenty of deaths. And keep in mind that these are just confirmed deaths due to flu; in many countries where surveillance is minimal or non-existent, we have no idea how many people were infected. It’s true that the number of deaths has been much lower than we feared, but back in the spring of 2009, no one knew how virulent this strain would be.

What I’d say to Wodarg (and what Dr. Fukuda might have wanted to say) is: Wodarg, you don’t know what you’re talking about. Your irresponsible claims are doing more harm than good. If you truly care about public health, then educate yourself before you speak out on the flu next time.

Now, why am I saying the pandemic is over? Well, in the U.S., the weekly surveillance reports from the CDC paint a very clear picture: the flu peaked in October and then declined rapidly, much like the seaonal flu does every year. Normally the peak occurs in January or February. Take a look at the latest data:In the past three pandemics, in 1918, 1957, and 1968, our surveillance wasn’t nearly as good, so maybe there will be two flu seasons this winter. It could happen – we could get a second wave – but I’m putting down my $0.25 that it’s over.

Notice something else about this figure? The normal seasonal flu hasn’t been seen at all! The graph shows that virtually all cases are pandemic H1N1 flu. In contrast, here are the past 4 years of flu seasons: See what I mean? Just one peak each year, and the color-coding shows that the normal seasonal flu is a mixture of H3N1, an older H1N1 (not the new strain), and influenza B.

How about Europe? It’s fading there too: the European CDC report for January 15 says

“Sentinel physicians collected 735 respiratory specimens, of which 139 (19%) were positive for influenza virus. This proportion has now decreased for the seventh consecutive week. … Of the 15 486 influenza viruses detected by sentinel networks and subtyped since week 40/2009, 15 393 (99%) were the pandemic virus."

So in Europe too the pandemic is on the wane, and the normal seasonal flu strains are virtually absent. For those who follow the evolution of the flu, this is quite remarkable. It means that exposure to pandemic H1N1 provides protection against all three of the seasonal flu strains, and it suggests that a large proportion of the population has been exposed to pandemic flu – otherwise, more people would be getting sick with seasonal flu. Pandemic H1N1 has out-competed the old strains in less than a year – the blink of an eye in evolutionary time.

So I think it’s over. But get your H1N1 flu shot! I just got mine. Why? Well, there is a small chance of a second wave, and there’s no downside to the vaccine: after 60 million flu vaccinations in the U.S., there hasn’t been a single reported case of injury due to the vaccine. In addition, the flu might come early again next fall, just as it did this year, and a vaccination now will likely protect you through next season. And finally, don’t forget that vaccinating yourself is also protecting your family, friends, and community.

I've just read Dr. Mercola's latest flu remedies, and I'm feeling scornful. I'm sorry, but Mercola is such an outrageous quack that he just leaves me astonished.His latest "reliable and safe" treatments, posted just yesterday, are a set of homeopathic remedies for the flu. When I saw the headline, I couldn't wait to read on: one of my favorite quacks, endorsing the most laughable of all quack remedies - how delightful!

It's a short article, and almost every line is wrong. Given Mercola's recent scare-mongering about the flu vaccine, which I wrote about a few months ago, I'm not surprised that he continues to push his own "natural" cures - that's how he makes money, selling ineffective treatments after making bogus claims about them. Let's look at how he says we should treat our flu symptoms.